New Updates to the American Heart Association Nutritional Recommendations

Poor diet quality is strongly associated with elevated risk of cardiovascular disease morbidity and mortality. The scientific statement by the AHA 2021 emphasizes the importance of dietary patterns beyond individual foods and nutrients, underscores the critical role of nutrition early in life, presents elements of heart-healthy dietary patterns and highlights structural challenges that impede adherence to these patterns. 

Dietary patterns encompass the balance, variety, and combination of foods and beverages habitually consumed. This includes all foods and beverages, whether prepared and consumed at home or outside the home. Adherence to heart-healthy dietary patterns is associated with optimal cardiovascular health.

Some heart-healthy dietary patterns emphasized in the Dietary Guidelines for Americans include the Mediterranean style, Dietary Approaches to Stop Hypertension (DASH) style, Healthy US-Style, and healthy vegetarian diets. 

The AHA’s new scientific statement is published in the journal Circulation. 

Healthy dietary patterns to promote cardiovascular health are summarized by the AMA as follows: 

1. Adjust energy intake and expenditure to achieve and maintain a healthy body weight.
2. Eat plenty and a variety of fruits and vegetables.
3. Choose whole grain foods and products.
4. Choose healthy sources of protein: mostly plants, a regular intake of fish and seafood, and low-fat or fat-free dairy products. If meat or poultry is desired, choose lean cuts and unprocessed forms.
5. Use liquid plant oils rather than tropical oils, such as coconut and palm, and partially hydrogenated fats.
6. Choose minimally processed foods instead of ultra-processed foods.
7. Minimize the intake of beverages and foods with added sugars.
8. Choose and prepare foods with little or no salt.
9. If you do not drink alcohol, do not start; if you choose to drink alcohol, limit the intake.
10. Adhere to this guidance regardless of where food is prepared or consumed.

The new scientific statement focuses on the value of an overall heart-healthy diet throughout one’s lifetime, rather than thinking of “good” or “bad” foods. 

The AHA statement emphasizes the role of lifelong healthy eating in warding off potentially dangerous heart-related conditions, including high LDL cholesterol levels, hypertension, obesity, type 2 diabetes, and metabolic syndrome.

The authors write that from early childhood onward, there is “well-documented evidence that the prevention of pediatric obesity is key to preserving and prolonging ideal cardiovascular health.” 

The AHA also recognizes that maintaining a healthy diet is particularly challenging for minoritized communities that are affected by structural racism.

According to the statement, many communities of underrepresented ethnicities and races lack access to healthy foods in local supermarkets. Such neighborhoods are served mostly by fast-food eateries and dollar store markets.

For the first time, the AHA cites food-related sustainability and environmental issues:

“There are increasing concerns about the environmental impact of current dietary patterns and food systems that favor animal-based food production and consumption, which contribute substantially to human-generated, greenhouse gas emissions and water and land usage.”

“Commonly consumed animal products, particularly red meat, have the largest environmental impact,” says the AHA.

The AHA concluded their scientific statement by adding: “Creating an environment that facilitates, rather than impedes, adherence to heart-healthy dietary patterns among all individuals is a public health imperative.” 

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Sources:

Alice H. Lichtenstiein, DSc, FAHA Chair, et al. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation. 2021;144:00–00. DOI: 10.1161/CIR.0000000000001031.

Robby Berman. (2021, Nov 10) American Heart Association updates heart-healthy dietary guidelines. Medical News Today. Retrieved from:
https://www.medicalnewstoday.com/articles/american-heart-association-updates-heart-healthy-dietary-guidelines 

Image from: 

A whole-food, plant-based diet is naturally high in fiber and low in calorie density. Getty Images stock. From:
https://www.today.com/health/how-lose-weight-doctor-names-best-healthy-diet-weight-loss-t170427 

Alice H. Lichtenstiein, DSc, FAHA Chair, et al. 2021 Dietary Guidance to Improve Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation. 2021;144:00–00. DOI: 10.1161/CIR.0000000000001031.